1/8. indocyanine green angiographic features of choroidal rupture and choroidal vascular injury after contusion ocular injury.PURPOSE: To report features of choroidal rupture and choroidal vascular injury after contusion ocular injury on indocyanine green angiography. methods: In a prospective study, nine patients (nine eyes) with choroidal rupture after ocular contusion underwent initial fluorescein angiography and indocyanine green angiography within 19 days after trauma. Eyes that had a distinct abnormality of the retinal pigment epithelium were excluded from this study. Subtraction indocyanine green angiography was also performed. Follow-up fluorescein angiographic and indocyanine green angiographic findings were also studied. RESULTS: Initial ophthalmoscopic examination revealed subretinal hemorrhage in all nine eyes. In five of the nine eyes, choroidal rupture was not seen on initial ophthalmoscopic or fluorescein angiographic examination because it was hidden beneath the subretinal hemorrhage, but it was detected on subsequent examinations. In the remaining four eyes, choroidal rupture was observed by ophthalmoscopy at the time of initial examination, and these eyes exhibited hyperfluorescent streaks on fluorescein angiography in the region of the subretinal hemorrhage. On initial indocyanine green angiography of all nine eyes, observed hypofluorescent streaks became more obvious with time. For each eye, there were more hypofluorescent streaks on indocyanine green angiography than hyperfluorescent streaks on fluorescein angiography. In one eye, the location of indocyanine green leakage nearly coincided with the location of a hyperfluorescent streak on fluorescein angiography. In this case, crescentic streaks of hypofluorescence were seen on the temporal side of the subretinal hemorrhage on indocyanine green angiography, although choroidal rupture was not observed in that region by ophthalmoscopy or fluorescein angiography. In two of the nine eyes, indocyanine green angiography and the subtraction technique demonstrated disturbance of flow into choroidal vessels, especially at the choroidal rupture site. CONCLUSION: After ocular contusion injury, various features of choroidal rupture and choroidal vascular injury were observed on indocyanine green angiography. This technique may contribute to the diagnosis of choroidal rupture and to the understanding of the clinical course after injury.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/8. Tumoral calcinosis: a case report with an electron microscopic study.A 68-year-old woman developed large subcutaneous masses on her abdomen and thighs after a bruise sustained in a traffic accident. She had severe pain when sitting up straight. Histological examination revealed calcified tissues in the entire dermis of the injured areas. On electron microscopy, crystalline materials were observed in the dermis, which seemed to be formed by the deposition of hydroxyapatite on unusual proteoglycan. In a vessel wall, a thick, layered basement membrane was observed. This suggests that vascular injury and subsequent hypoxia play a role in the process of calcinosis. We performed a partial resection with good results in alleviating the patient's pain.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/8. Cardiac and great vessel injuries in children after blunt trauma: an institutional review.PURPOSE: The purpose of this study was to review the incidence of cardiac and great vessel injury after blunt trauma in children. METHOD: A retrospective review of 2,744 patients with injuries from blunt mechanisms was performed. RESULTS: Eleven patients sustained cardiac injury. Four patients had clinically evident cardiac contusions. All recovered. Four patients who died from central nervous system injury were found to have cardiac contusions at autopsy. None had clinical evidence of contusion before demise. One patient had a traumatic ventricular septal defect (VSD) that required operative repair. autopsy findings showed a VSD in another patient, and a third patient was found to have a ventricular septal aneurysm that was treated medically. Two patients had great vessel injuries. One patient had a contained disruption of the superior vena cava that was managed nonoperatively. Another patient had a midthoracic periaortic hematoma without intimal disruption found at autopsy. One patient had cardiac and great vessel injuries. Discrete aneurysms of 2 coronary artery branches and the pulmonary outflow tract were identified by cardiac catheterization. This patient was treated nonoperatively. CONCLUSIONS: Cardiac and great vessel injury after blunt trauma are uncommon in children. Cardiac contusion was the most common injury encountered but had minimal clinical significance. Noncontusion cardiac injury is rare. No patient with aortic transection was identified.- - - - - - - - - - ranking = 8keywords = vessel (Clic here for more details about this article) |
4/8. Unknown AV-fistula as reason for post-traumatic hematoma of the thigh.A case is reported of a 28-year-old patient with gradually developing massive swelling of the right thigh after sustaining a blunt trauma. 3 1/2 months after the injury, surgery was performed because of a persisting tumor at the thigh. Intraoperatively, massive bleeding occurred, the bleeding vessel was sutured. Postoperative angiography disclosed arteriovenous (av) fistulae from the internal iliacal artery to a gluteal vein as source for the bleeding. The feeding artery was closed by coiling, the patient recovered completely. To the authors' knowledge, development of an av-fistula following blunt trauma has not been described previously. Similarly, the differential diagnosis of a posttraumatic bleeding of a congenital av-malformation was not yet reported. The authors emphasize, that prior to the surgery of inadequately behaving hematomas, an angiography should be performed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/8. The contused kidney, an angiographic picture.Problems in the interpretation of an angiogram of a contused kidney are reported. The angiogram showed signs of avascularity and tumor vessels and a malignancy was considered. However, on operation the kidney appeared to be contused but otherwise normal. One should be aware of the possibility of pitfalls arising in early angiograms of contused kidneys.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/8. The role of coronary artery injury and perfusion in the development of cardiac contusion secondary to nonpenetrating chest trauma.Myocardial contusion secondary to nonpenetrating chest trauma can occur in the absence of any identifiable large vessel coronary artery occlusion or injury. It has also been reported in association with coronary artery atheromata, thrombosis, rupture, and fistula formation. After reviewing the clinical and experimental research literature, we conclude that myocardial contusion necrosis results from changes in perfusion of small vessels and the coronary microvasculature. Coronary arteriography and emergency coronary artery bypass surgery do not appear promising as therapeutic modalities to reduce myocardial necrosis in this condition. More appropriate therapeutic emphasis may result from research efforts to develop pharmacologic interventions to preserve contused myocardium similar to those currently being evaluated in the management of patients with ischemic myocardium secondary to coronary artery disease.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
7/8. retinal detachment with tear in the posterior fundus following ocular contusion.Two unusual cases of rhegmatogenous retinal detachment following contusion to the eyeball showed retinal tears at the posterior fundus close to the optic disc and the large retinal blood vessels. In both cases, the tears were not detected immediately after the injury due to a coexisting vitreous hemorrhage. Both patients were successfully treated by pars plana vitrectomy, air-fluid exchange, and endolaser photocoagulation. During vitrectomies, an adhesion of the vitreous to the flap or the operculum of the tear was observed, with detachment of the remainder of the posterior vitreous from the retina. vitrectomy allowed a more complete resolution of posterior tractional forces than scleral buckling, and eliminated the vitreous hemorrhage.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/8. An unusual presentation of liver laceration in a 13-yr-old football player.Abdominal injury occurs infrequently from athletic trauma, yet when it does occur, it can be very serious. Although rupture of a major blood vessel can lead to rapid loss of blood, insidious blood loss can also result from apparently insignificant injury of the spleen, liver, or kidney and lead to delayed problems. awareness of the potential for such injury is vital because outcome can be adversely affected by a low index of suspicion, and this can be compounded by the fact that the initial physical examination is not always a reliable indicator of the severity of injury. Classic reports of these injuries describe splenic injury from a left-sided blow and hepatic injury from right-sided trauma. We present a case report of liver laceration in a young football player not only to comment on its unusual mechanism and presentation, but also to illustrate the importance of rapid assessment and transport of the athlete with a serious abdominal injury to avoid the consequences of delayed diagnosis and treatment.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |